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Membership Application

PARSAC membership is open to cities, towns and public agencies providing municipal services. Participation in either the Liability or Workers' Compensation Program is required and all applications are subject to approval by PARSAC's Board of Directors and excess providers.

If your entity is interested in membership with PARSAC, please download and complete the below application. The completed application should be submitted to PARSAC along with the appropriate underwriting fee and a loss report for each Program applied to. Loss reports should provide five years of data for all opened and closed claims, including total incurred expenses and reserves. The fee enables us to perform a complete underwriting analysis, including on-site interviews and actuarial studies, and will be credited toward the first year premium.

If you have any questions regarding the application process, please feel free to contact us at (800) 400-2642 or complete the form below.